人工股骨头置换治疗严重股骨转子间骨折的生物力学研究
黄炳生, 王永胜, 陈顺仪, 陈立安, 钟世镇, 丁自海
中国临床解剖学杂志 ›› 2012, Vol. 30 ›› Issue (6) : 683-686.
人工股骨头置换治疗严重股骨转子间骨折的生物力学研究
The biomechanical study of severe intertrochanic fractures treated with cemented femoral stem
目的 探讨人工股骨头置换(标准柄)治疗股骨转子间粉碎性骨折的生物力学稳定性。 方法 收集18根成年股骨标本随机分成置换组、DHS组及对照组。置换组(A组)(n=6)模拟股骨转子间四部分骨折,钢丝捆扎固定大小转子及股骨矩,行标准柄股骨头置换,骨水泥固定;DHS组(B组)(n=6)模拟股骨转子间四部骨折,行DHS钢板内固定;对照组(C组)(n=6)采用完整股骨标本。Bose3510-试验机上行轴向加压和扭转测试,测量三组标本位移变化并行统计学分析。 结果 轴向压力测试:垂直加载100~1000N,A组与C组两组间差异没有统计学意义(P>0.05);B组与C组及A组与B组的组间比较差异有统计学意义(P<0.05)。扭力测试:当扭矩是8 Nm时,A组与C组及A组与B组间比较差异无统计学意义(P>0.05),B组与C组比较差异有统计学意义(P<0.05)。 结论 应用骨水泥型股骨标准柄假体进行人工股骨头转换置换治疗股骨转子间粉碎性骨折的生物力学性能是具有可行性的。
Objective To study the biomechanical stability of the comminuted intertrochanic fracture treated with cemented standard femoral stem prosthesis. Methods 18 cadaveric femurs were selected in this study and divided into three groups randomly as FHR, DHS and control group. The FHR group(A)(n=6) was simulated as comminuted intertrochanic fractures as four parts which were treated with cemented femoral prosthesis following standard hemiarthroplasty procedure and the four parts fractures in FHR group were fixed by wires additionally. The DHS group (B) (n=6) was also simulated as comminuted intertrochanic fractures as four parts which were treated with DHS internal fixation systems. The control group (C) (n=6) was raw cadaveric femur. The specimens were tested mechanically by universal testing machine through vertical and rotational loading. The displacement of loading were recorded and analyzed. Results Vertical loading tests: No significant differences of displacement were found between group A and C either in vertical loading from 100N to 1000N or in rotational loading with torque of 8Nm. There was statistically significant difference between group B and C, also group A and B in vertical loading. In rotational loading test, there was statistically significant difference between group B and C, and no significant difference between group A and B. Conclusions The use of cemented standard femoral stem prosthesis is biomechanically acceptable in the treatment of comminuted intertrochanic fractures.
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广州市科技计划项目(2010Y1-C581)
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